2018 Day Conference
Global Palliative Care: Focus on the Family
Principal speakers included David Oliviere, former Head of Education at St. Christopher's Hospice, Liz Bryan, currently in that role, Dr. Martin Becker and Helen Bennett. We also had three overseas visitors, who were on the St. Christopher's International Bursary Scheme. Presentations from the speakers will in due course be found in our Resources section, together with a short presentation describing PCW's January 2018 Training of Trainers programme in Addis Ababa (see below)
Two other notable events took place at the Conference. The Chair of Palliative Care Works passed from Gillian Chowns to Ruth Wooldridge during the AGM. Gillian has chaired PCW from the outset, and will remain one of our trustees.
We also took the opportunity to celebrate the tenth anniversary of the Palliative Care Toolkit, with which we have been intimately associated. This key resource for Palliative Care practitioners was written by Dr. Charlie Bond, Dr. Vicky Lavy, and Ruth Wooldridge, and the authors are seen in the photo about to cut a celebration cake!
Further training in Addis Ababa
After the January course, the teaching team, consisting of George Smerdon, Ruth Wooldridge and Gillian Chowns, visited most of the city hospitals involved in the programme, and were very pleased to note the progress being made to establish palliative care.
Global grant from Rotary International
The powerpoint presentations used at this conference will soon be available in the Resources section of this website.
New PCW project in Ethiopia gets under way - November 2016
The team from PCW consisted of Dr. George Smerdon, Ruth Wooldridge and Dr Gillian Chowns, and they were accompanied by Mrs Christine Davies, District Governor elect, East Midlands Rotary Clubs (UK). The visit was planned in consultation with Dr Nicola Ayers, PhD, MSc, BSc (Hons) RN, the Palliative Care Adviser to the Ethiopian Federal Ministry of Health. It is intended to be the first element of a programme spread over two to three years, aimed at developing palliative care skills through training and mentoring, and in a sustainable manner.
The training programme was held at the ALERT Hospital training centre. There were 28 participants in all, Health Officers and Nurses, from eight of the Health Centres linked to the four hub hospitals in Addis Ababa. In addition there were two senior nurses from the Prison Service as well as an observer, another senior nurse, from St Paul’s Hospital (one of the hubs).
We were delighted that Dr Desalegn, Head of the Clinical Services Directorate, Federal Ministry of Health, was able to officially open the course, and return to present certificates at the conclusion.
Chairman's Report to the AGM, September 2016
My report will be fairly brief and I will focus on the last 12 months. In terms of overseas visits it has been a relatively quiet period, but behind the scenes we have all been busy.
The review of the Palliative Care Toolkit, originally written by Vicky, Charlie and Ruth, involved a substantial amount of work. While Jane, Ruth, Karilyn and I all worked on individual chapters, Charlie was editor in chief and certainly contributed the lion’s share of the work, for which many, many thanks are due. Two Skype meetings lasting five hours in total were only a portion of the hours put in on the review.
A second substantial piece of work has been the preparation, planning and negotiations in relation to the forthcoming project in Ethiopia. Ruth, our networker par excellence, brought PCW and the supporting organisation together, and thereafter George has ably led a small sub-group, including Ruth, and me, which has been working with the donors and the PC advisor to the Ethiopian government, Dr Nicola Ayers.
Over the years in which we have been operating, our bank balance has grown steadily. Our costs are low, since we do not have an office or any paid staff. We meet Trustees’ expenses, naturally, and have some administrative expenses, but otherwise the fees we have accumulated are used to further our work. During this past year we have contacted a number of pc sites, where we have taught or mentored in the past, and offered the possibility of pro bono work. Negotiations with Homa Bay Hospital pc team have been fruitful and a costed proposal is before the Board today.
Following on from an excellent suggestion from Karilyn, we decided to spend some of our funds on three Bursary Awards to enable overseas colleagues, with whom we had worked as PCW members, to present a paper or poster at the APCA conference. Although the process was not straightforward and there are lessons for the Board to learn, we were please d to be able to award 3 bursaries, to a paediatrician from Kenya, a nurse from Zambia, and a surgeon from Ghana. As this last winner had already attracted some funds from elsewhere, we were able to split the third award and also partially fund a social worker from Tanzania.
Not only did the Bursaries ensure that individuals, who might have not otherwise been able to afford to attend, both attended and presented and were exposed to a wider world of pc, but they also helped to raise the profile of PCW. In particular, both APCA and KHEPCA were warm in their appreciation of our support.
As we had ourselves successfully submitted an abstract on mentorship, our Board also agreed to fund the attendance of two members. Jane and I were fortunate to be the formal PCW representatives and as George and Karilyn and Richard were also there, PCW had a significant presence. Between us, we endeavoured to cover almost all the plenaries, presentations and workshops, and we will be reporting on some of the highlights after this AGM.
Finally, I should note that we have invested time, creativity and some modest funds in publicity. Our new logo is on all materials, and looks particularly good on the roller banner which Stephen designed and organised. It also graces the new PCW bags from the Good Bag Company, which comfortably hold a TK and Trainer’s Manual and much else. These arrived in time for us to use at the APCA conference and we had several requests from former students and mentees to have one, so there are now PCW bags in Kenya and Zimbabwe publicising our work.
As most of you will know, the first edition of our new twice-yearly newsletter has come out and has been sent to everyone on our database. We are also formalising our growing list of contacts by setting up a Friends of PCW category and the Newsletter contains an invitation to become a Friend (completely free!). In this way, we hope to be a point of contact (or hub, as today’s word seems to be) for any and all who have a passion for pc in resource-poor settings.
And the future? The coming 12 months promise to be busy again, with work in Ethiopia in November this year and a further visit in May 2017, mentoring in Homa Bay in Spring next year, and discussions with pc services in Ghana and the Seychelles on the horizon. All of this, of course, depends on the energy, passion and commitment of the team you see here and it is a privilege and a pleasure to work with them all.
Autumn Conference and Annual General Meeting, Oxford
Contributions were also made by Dr Catherine D'Souza and Dr Fiona Rawlinson.
Several trustees reported on their recent visit to the APCA conference in Kampala.
News was also given of PCW's plans to work in Ethiopia and Kenya in the next six months. Look out for more information as it becomes available!
Some of the conference delegates
APCA Conference 2016, Kampala
The team were very pleased to meet the recipients of our bursaries, awarded to Eseenam Agbeko, Prospellina Ndhlovu, Meshack Liru and Edgar Ngelangela, all of whom made valuable contributions to the conference.
Conference 2015 -
'Global Palliative Care - working towards sustainability
There were 46 delegates, and speakers included Prof. Julia Downing, Carolyn Miller CBE, Angela Kaiza from MGIT, Dar es Salaam, Dr Fiona Rawlinson from Cardiff University, and the BBC's Global Health correspondent, Tulip Mazumdar. Visitors included four students who had just completed a programme at St. Christopher's Hospice: Oussematou Dameni from Cameroun, Dr. Roger Ciza from Burundi, Yvonne Telamaque and Anges Louis-Marie from the Seychelles.
The programme was chaired by Mike Wooldridge, broadcaster and journalist, who has particular knowledge of palliative care in East Africa and India.
The main conference presentations are now available on our resources page
Presentations by overseas visitors, who had been attending the multi-professional programme at St. Christopher's Hospice, have also been added.
Further support for Palliative Care in Ghana
At the beginning of November 2013 a weekend conference was jointly organised by PCW and our Scottish partner Cairdeas, to explore issues in mentoring and the use of the Palliative Care Toolkit. The conference took place at Brockington Hall in Herefordshire, England, and was attended by 48 delegates, including a number from the mentoring programme which is now under way in several African countries under the auspices of THET (the Tropical Health and Education Trust). Mentors are already engaged in links with hospitals in Kenya, Rwanda, Zambia and Uganda. The conference provided - among other things - an opportunity for those who had already travelled to their link hospitals to share experiences and impressions with those who had yet to travel to their placements.
Another key component of the conference programme was the opportunity to explore the use of the Palliative Care Toolkit and its associated training manual.
Training of Trainers course, in Tanga, Tanzania
Participants on the course came from eight sites (seven District Hospitals and the Regional Hospital) and were all part of the palliative care team in their districts. The course was quite challenging, covering aspects of learning and management, and allowing all participants an opportunity to try teaching from the Palliative Care Toolkit using the modules in the training manual. Each district will now conduct a training course for volunteers and workers in health centres in the first half of 2013, in order to bring palliative care down to village level.
A partnership with CAIRDEAS
This is a two-year programme, building on successful pilot projects, which will increase the capacity of community and hospital-based health workers to develop front line palliative care training and services in the Tanga region of Tanzania and in Uttar Pradesh, India. The programme will be based on the Palliative Care Toolkit. It will be a model for scaling up, that is sustainable, appropriate in both cultures, is low cost, and can be replicated in both a hospital and community setting.
The project runs from September 2012, and a ‘training of trainers’ course will be held in Tanga in November.
Palliative Care courses in Accra, Ghana
A month later Helen Bennett from PCW joined the teaching team for a three-day programme focusing on children’s palliative care, also presented at Korle Bu. There were 45 participants drawn from several regions of Ghana.
Both courses were very well received; and PCW is delighted to have contributed to the development of palliative care in Ghana.
Research project completed
Both pieces of work were completed in late autumn of last year and the Report can be found on the Forces Support website www.forcessupport.org.uk
We are pleased announce that we have recruited three new Associates to our team - Dr Richard Collins, Dr Michael Minton, and Dr George Smerdon all bring a range of skills and experience to PCW, and we are delighted to have them on board.
Spreading the word – from the Lake shore to Shinyanga
As ever, the course was multi-professional, and included pharmacists, medics, social workers, clinical assistants, nurses and a chaplain, so the combined experience was rich and diverse. The teaching team was augmented, on different days, by Dr Grace Morris, who had been a mentor for the Kolondoto team the previous year, and by Cosmos Baltazar, the pharmacist who had been one of the first palliateurs to complete a Toolkit training.
Participants responded enthusiastically to the very interactive and participative style of teaching, and the end of course evaluations indicated significant new knowledge as well as a shift in attitudes to such issues as use of morphine and breaking bad news. Both of these were topics on which course members would have liked even more teaching.
On the final day, all the teams represented – Shinyanga Regional Hospital, Shirati PC team, Geita and Kolondoto staff – worked in their own groups to produce Implementation plans appropriate to their own contexts. These have been shared with the Palliative Care Co-ordinator for Lake Zone, Amani Chomolla, who will continue to support and monitor the work in the months ahead.
While education in itself is not enough – and experience shows how crucial a mentor can be in embedding the learning in day to day practice – the PCW team, and indeed, the participants themselves, left the course confident that palliative care had taken another step forward in the Lake Zone and that both its concept and practice are gradually becoming more integrated within the health care system and within the local communities. There may still be a long way to go, but as the African proverb has it: ‘There is only one way to eat an elephant – one bite at a time”!
Mentorship with PCW
When Muheza was asked by the Diana Princess of Wales Memorial Fund in 2008 to extend palliative care into the rest of Tanga region they willingly took up the challenge, knowing that they had plenty of trained staff with which to do this. The programme was to train a team at the regional and all the district hospitals, to mentor this team, and help them form links with home based care to provide care in the community. The training was carried out using the Palliative Care Toolkit and the Training Manual.
Within a short time of starting the programme, several key players moved to other posts and it was necessary to look outside Tanzania for help to mentor the roll-out programme. The first mentors for the roll-out were a Canadian couple, Ambrose Marsh and Leah Norgrove, palliative care specialists from British Columbia, who advertised in the WHPCO journal for a sabbatical opportunity. Tanga was the place for them and they spent six months there in 2009/2010 helping to establish the team at the regional hospital.
Since then mentors from the UK have been sent out to all the other six district hospitals. All the mentors have remained in active contact with their teams after their initial visit of between three and six months. This model has since been replicated in Lake Zone in a Tearfund programme to initiate palliative care in three of their home based care programmes. Mentors have again been recruited and have been to all sites after the initial Toolkit training course run by PCW.
The mentorship model has been very successful and enjoyed by both the mentors and the teams they have been mentoring. It has been described as a 'life changing experience' by several of the mentors. All those involved in the Tanzanian mentorship programme met for a weekend in November 2011 to exchange experiences and look at the way forward for palliative care in Tanzania and particularly with respect to mentorship. A very lively and enthusiastic weekend was enjoyed by all.
So far our mentors have been either doctors or nurses but we are very happy to consider anyone with an interest in palliative care from any health related discipline. This year we hope to extend the scheme from Tanzania to India. The mentors are completely self funding. Anyone interested in learning more about mentorship, please contact us through the website.
Karilyn Collins awarded the MBE
The video ‘Frontline Palliative Care’
‘Frontline Palliative Care’ powerfully illustrates the need for both community and hospital-based palliative care, and includes interviews with doctors, nurses, patients and carers, as well as the Director of Nairobi Hospice, Dr. Brigid Sirengo and the Director of the Kenya Hospice and Palliative Care Association (KEHPCA) Dr. Zipporah Ali.
January 2011: Aidsrelief in Dar es Salaam
The training lasted for five days and 33 members of AR staff attended. At the end of the training it is expected that these staff will monitor and evaluate the palliative care already established in Tanga region and also promote palliative care in the other three regions. PCW has previously been instrumental in training teams in some hospitals in Mwanza and Mara, and AR will help this programme to escalate.
The enthusiasm and active participation in the workshop by the AR staff left the PCW team in no doubt that palliative care was now on the AR agenda and would be part of their routine care and treatment for people with HIV and for other patients in need.
We are grateful to the Diana Princess of Wales Memorial Fund for financing this workshop.
PCW and Mentorship
Chris starts in April 2011, and we look forward to putting his report on this website in due course.
PCW in Ghana
The conference was attended by about 100 participants from 11 out of the 12 regions of Ghana; a mixed group of physicians, surgeons, nurses, pharmacists and social workers. They were a keen and lively audience and the three days packed in a huge amount of material. One outcome of the conference was that Dr. Verna Vanderpuye, head of the department of Radiotherapy at Kohle Bu Hospital in Accra, has been invited to be the government advisor on palliative medicine.
2010: Mwanza, Tanzania
The programme is highly participative and places emphasis upon multi-professional working. The teams that took part include doctors, nurses, social workers and pastors.
Karilyn Collins, Gillian Chowns and Ruth Wooldridge used the Palliative Care Toolkit as the principal resource for the five-day programme. The Toolkit proved to be a very useful and appropriate resource on which to base the teaching. It addressed all the key topics at a level and in a style that met the participants’ needs and understanding. The three facilitators had all been involved to varying degrees in the concept, writing and production of both the Toolkit and its companion publication, the Toolkit Trainer’s Manual, and therefore had a thorough understanding of its underlying philosophy.
The establishment, and training, of the three district palliative care teams in Shirati, Shinyanga and Geita has been promoted and funded by Tearfund.
Working with Tearfund
Palliative Care for Save the Children Fund
On October 23rd 2008 Dr Karilyn Collins of Palliative Care Works met with Dr Marleen De Tavernier, the health programme manager, and Cecile Marchand, the child protection officer, of Save the Children Fund in Tanzania. Karilyn had been commissioned by the Diana, Princess of Wales Memorial Fund to discuss ways in which palliative care could be included in the work that Save the Children was doing in Tanzania. They had a very full and interesting discussion, some outcomes of which are still in the planning stage.Karilyn will be speaking in London on World Aids Day (Dec 1st) to senior administrators of Save the Children Fund about the importance of palliative care for children with HIV/AIDS.
Palliative Care Toolkit - November 2008
Dr Vicky Lavy and Dr Karilyn Collins, from Palliative Care Works, recently held a one-week workshop teaching basic palliative care using the new Palliative Care Toolkit training manual. There were 17 participants, including doctors, nurses, pharmacists and a social worker, from Bombo Hospital, Tanga (the regional hospital) and Tanga City (three health centres within the city of Tanga ).
The workshop was divided into 90 minute modules, covering topics from team building, communication skills, breaking bad news, spiritual issues and bereavement to pain relief, the use of morphine, dealing with other symptoms, and end of life issues. On the final day the participants enthusiastically planned how they would form their own palliative care teams and implement what they learned in their existing practice.Each participant received a copy of the palliative care toolkit and felt confident in using it.
The toolkit training manual is still under development, and the valuable experience gained from this week will be included in the final version.
Lambeth Conference 2008
During the Lambeth Conference of the Anglican Communion, held at Canterbury in the United Kingdom, one of our partners, Ruth Wooldridge OBE, addressed a special interest meeting on issues of palliative care. She introduced a number of visiting bishops from sub-saharan Africa to the 'Palliative Care Toolkit' which has been developed with the support of 'Help the Hospices'. It is intended to help in the training of palliative care practitioners in situations where resources are limited.